Job Summary: We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Case Management Coordinator to join our Case Management team. Our organization promotes autonomy through a Monday-Friday working schedule 8am-5pm and flexibility as you coordinate the care of your members. Case Management Coordinator is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Case Management Coordinator will effectively manage a caseload that includes supportive and medically complex members. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness through integration. Case Management Coordinators will determine appropriate services and supports due to member's health needs; including but not limited to: Prior Authorizations, Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports. Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports. Responsibilities: Coordinates case management activities for Medicaid Long Term Care/Comprehensive Program enrollees. Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources. Conducts comprehensive evaluation of Members using care management tools and information/data review Coordinates and implements assigned care plan activities and monitors care plan progress Conducts multidisciplinary review to achieve optimal outcomes Identifies and escalates quality of care issues through established channels Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs Experience: One year Case management experience A MUST / Case Management Certificate ( Preferred)
...throughout the Club. You will maintain overall HR functions such as recruitment, orientation, policies, regulatory compliance, compensation... ...in Human Resources Management, Business Administration or Hospitality preferred. Hospitality/Private Club related experience. PHR (...
About the Role At Care Options for Kids, a pediatric home health care company providing one-on-one care in the home, we do things a little... ...the families you care for. Benefits forLicensed Vocational Nurses (LVNs) / Registered Nurses (RNs) Up to $2,500 Bonus for qualified...
...Job Description St. Francis Hospital is seeking a Sr. Vice President/Chief Nursing Officer (CNO). The Senior Vice President is the Nurse Executive for the Department of Nursing and a member of the executive management team who is responsible for the administrative and...
Welcome to Abrazo Health Network, where making a real difference in people's lives is at the heart of everything we do. Beyond just medical treatments, we believe in the power of genuine relationships and heartfelt compassion. It's what sets us apart and makes us truly...
We are the leading provider of professional services to the middle market globally, our purpose is to instill confidence in a world of change, empowering our clients and people to realize their full potential. Our exceptional people are the key to our unrivaled, inclusive...